What Is the IRS 213 Medical Expense Deduction?

The federal tax code, under Internal Revenue Code (IRC) Section 213, allows taxpayers to lower their taxable income by deducting certain medical expenses. It is designed to offer financial relief for significant out-of-pocket medical spending that is not covered by insurance or other means.

This tax benefit is for costs that exceed a specific percentage of a taxpayer’s income. To utilize this deduction, one must itemize deductions on their tax return instead of taking the standard deduction. For many, the standard deduction is higher and simpler to claim, but for those with substantial medical bills, itemizing can result in tax savings.

Defining Qualifying Medical Expenses

The Internal Revenue Service (IRS) defines medical care broadly, encompassing payments for the “diagnosis, cure, mitigation, treatment, or prevention of disease.” This definition also includes costs for treatments that affect any structure or function of the body. The expenses must be for the taxpayer, their spouse, or their dependents, and must be unreimbursed amounts.

Common examples of deductible expenses include:

• Payments made to doctors, dentists, surgeons, chiropractors, psychologists, and psychiatrists
• Costs of hospital care, including inpatient meals and lodging
• Prescription medications, over-the-counter medicines, and insulin
• Payments for eyeglasses, contact lenses, hearing aids, and dentures

Premiums paid for medical insurance policies, including amounts for Medicare Part B, can be counted. Transportation costs for medical care are deductible, which can include fares for taxis or a standard mileage rate (21 cents per mile in 2025) for using a personal vehicle. The costs of programs to stop smoking or for weight loss are deductible if they are part of a treatment for a specific disease diagnosed by a physician.

Conversely, the IRS has a clear list of expenses that do not qualify. Cosmetic surgery is not deductible unless it is necessary to improve a deformity from a congenital abnormality, an accident, or a disfiguring disease. Expenses for general health, such as vitamins or gym memberships, are not allowed unless prescribed by a doctor to treat a specific medical condition.

Any medical costs paid using funds from a tax-advantaged account like a Health Savings Account (HSA) or a Flexible Spending Account (FSA) cannot be deducted. This is because the funds in these accounts already receive preferential tax treatment. The expense must be an out-of-pocket cost paid with after-tax dollars.

Calculating the Deductible Amount

The ability to deduct medical expenses is limited by a threshold based on a taxpayer’s Adjusted Gross Income (AGI). AGI is a figure calculated on Form 1040 that represents gross income minus certain “above-the-line” deductions. Under current law, you can only deduct the amount of qualifying medical expenses that exceeds 7.5% of your AGI.

The calculation process involves a few distinct steps. First, you must sum all of your qualifying medical expenses paid during the tax year for yourself, your spouse, and your dependents. This total should only include costs that were not reimbursed by insurance, your employer, or paid for with tax-advantaged funds from an HSA or FSA.

Next, you must locate your AGI on your Form 1040 tax return. Once you have this figure, you multiply it by 7.5% (or 0.075) to determine your specific limitation amount. This result represents the portion of your medical expenses that you are not permitted to deduct.

The final step is to subtract the 7.5% AGI threshold from your total qualifying medical expenses. If your expenses are greater than the threshold, the difference is the amount you can claim as an itemized deduction. For example, a taxpayer with an AGI of $80,000 and total medical expenses of $9,000 would calculate their threshold as $6,000 ($80,000 x 0.075). Their deductible amount would be $3,000 ($9,000 – $6,000).

Information and Records for Claiming the Deduction

The IRS requires taxpayers to maintain detailed and accurate records to substantiate the expenses they claim. You should keep these documents organized throughout the year to make tax preparation smoother.

The types of records needed are specific. You should retain:

• All receipts and invoices from medical providers, such as doctors, dentists, and hospitals
• Prescription records from pharmacies
• The Explanation of Benefits (EOB) statement from your insurance company
• A mileage log for medical-related travel detailing the date, destination, and mileage

All of these records will be used to calculate your total expenses, which are reported on Schedule A (Itemized Deductions) of Form 1040.

While you do not need to submit these records with your tax return, you must have them available in case the IRS selects your return for an audit. Keeping these documents accessible for at least three years after filing is a standard practice.

How to Report the Deduction on Your Tax Return

Once you have calculated the deductible amount, the final step is to report it on your tax return. This deduction is reported on Schedule A, Itemized Deductions.

The first four lines of Schedule A are dedicated to medical and dental expenses. You will enter your total qualifying medical expenses on line 1. The form then guides you to enter your AGI, perform the 7.5% calculation, and arrive at your final, allowable medical expense deduction on line 4.

This calculated medical expense deduction is then combined with your other itemized deductions, such as state and local taxes, home mortgage interest, and charitable contributions. The sum of all itemized deductions is calculated on Schedule A and then transferred to your main Form 1040.

If the total of your itemized deductions on Schedule A is greater than the standard deduction amount for your filing status, you will generally benefit from itemizing. The medical expense deduction can be a significant component of this calculation for those with substantial healthcare costs.